No abstract

OOC, an oral therapeutic peptide, achieves efficacy in controlling IGF-1 and GH after switching from injectable SRLs for up to 13 months, with a safety profile consistent with approved SRLs. OOC appears to be effective and safe as an acromegaly monotherapy.

No abstract

There is a blood-brain barrier (BBB) for GH. A certain, unknown amount of GH passes the BBB, acts on the neuronal GH receptors and directly influences the brain mechanisms serving the feedback and ultradian secretion of GH. The high density of GH receptors in the choroid plexus suggests a possible receptor-mediated transcytosis transport. The effects of GH on brain development, neuronal plasticity and neuroprotection seem to be mediated by IGFs. GH and IGFs are also synthesized in the brain. The relative contributions to brain functions of GHs produced inside and outside the BBB are unknown. The cerebrospinal fluid (CSF) space is the compartment inside the barrier accessible to clinicians. High GH levels in CSF were reported in acromegaly and also a small increase was reported after chronic administration of hGH in GH-deficiency syndromes. For the practitioner it is necessary to determine the normal range of hGH levels in CSF.

The OST is a reliable tool for the selection of patients with active acromegaly who will achieve 'safe' GH levels on therapy with LAR. Its prognostic profile is less optimal for patients treated with LAN. If GH values during the test fall < 5.25 mU/l (in case of LAR treatment) or < 6.05 mU/l (in case of LAN treatment), there is a 92-94% chance of subsequently achieving 'safe' GH levels after up to 6 months treatment with either of these agents.